Transcript Cardiac Stent

Coronary Stent
Megan French
What is a Stent
• A small, mesh-like
device made of metal
• Acts as a support or
scaffold, in keeping
the vessel open
• Stent helps to improve blood flow to the heart
muscle and reduce the pain of angina
• 80% of patients who have balloon angioplasty will
have a stent placed as well.
Types
Bare metal stents:
– Traditional method
– May have an increased rate of
re-narrowing due to growth of scar
tissue in the stent, a condition
called Restenosis.
Drug-eluting stents:
-Combat Restenosis
- Coated with medications that are slowly released to
block the body's ability to form scar tissue
around the stent. The medication is delivered
directly to the site of the artery blockage.
History
• Percutaneous transluminal coronary angioplasty
(PTCA) by Gruntzig in 1977
• Puel and Sigwart, in 1986, deployed the first
coronary stent to act as a scaffold
• In 2001, drug-eluting stents (DES) were
introduced as a strategy to minimize restenosis
Procedure
• First a catheter is inserted in the groin or arm. After the catheter is
in place a wire will be guided through the artery until it reaches the
blockage in the heart. A soft, flexible catheter tube will be slipped
over the wire and threaded up to the blockage.
• The doctor will be taking x-ray pictures during the procedure and
dye will be injected into the arteries of your heart.
• Once the blockage is reached, a small balloon at the tip of the
catheter will be rapidly inflated and deflated. This will stretch the
artery open.
• The collapsed stent will be inserted. The balloon will be inflated
again to expand the stent to its full size. The stent will be left in
place to hold the vessel walls open. The deflated balloon, catheter,
and wire will be removed.
Future Advancements
• The ReZolve™ stent integrates a proprietary
drug-eluting polymer and a novel design to
create a stent with metal-like performance out
of a polymer material.
• The stent restores blood flow and supports
the artery through healing, then completely
dissolves from the body, leaving the patient
free of a permanent implant.
Future
Advancements
• Unlike permanent metal alloys, the REVA polymer
dissolves from the body after healing of the artery
has occurred, leaving additional treatment options
available in the future.
• Another unique feature of the polymer is that it is
visible under x-ray, allowing the stent to be visualized
during the implant procedure and at follow up. Other
bioresorbable polymer stents are invisible and require
permanently attached radiopaque markers to aid in
their placement.
References
• J Am Coll Cardiol, 2000; 35:1288-1294
© 2000 by the American College of Cardiology Foundation
• Maria Alexandra Rodriguez, David L Fischman, Michael P Savage.
(2010) Advances in vein graft intervention. Interventional
Cardiology 2:5, 735-754
• Masahiro Jinzaki, Minoru Yamada, Yutaka Tanami, Sachio
Kuribayashi. (2011) Evaluation of In-Stent Restenosis by High Spatial
Resolution CT. Current Cardiovascular Imaging Reports
• http://texasheart.org/HIC/Topics/Proced/angioplasty.cfm
• http://www.nhlbi.nih.gov/health/health-topics/topics/stents/
• J. Am. Coll. Cardiol., November 7, 2011; (2011)
j.jacc.2011.08.007v1.
• Serruys PW, Kutryk MJB, Ong ATL. Coronary-artery stents. N Engl J
Med 2006;354:483-95.